The breasts are glands consisting of ducts embedded in fatty tissue. Breast cancer is considered to be the most commonly occurring cancer in middle-aged women. Breast cancer can arise anywhere in the duct system: from the nipple to the terminal lobule. Breast cancer is a potentially lethal disease, and the earlier it is detected, the more likely it can be successfully treated.
However, breast cancer is often detected only after it has spread to other parts of the body. Frequent breast exams are therefore essential for early identification and treatment. The breast self-exam should be performed as frequently as every month, immediately following the menstrual cycle.
Breast self-examination methods are well known. For example, most methods include visual inspection and tactile inspection:
Step 1—Visual Inspection
Look for changes in the skin over each breast—redness, swelling, or puckering.
Look for nipple changes—discharge, scaling, or indentation.
Step 2—Tactile Inspection
Physicians recommend using at least one of three tactile breast examination methods: The Circle method, The Line method, and The Wedge method.
The Circle Method includes moving the three middle fingers in an inward spiral pattern starting from the outer edge of the breast until the nipple is reached. The Line Method includes moving the three middle fingers in a raster pattern, starting from underarm area down below the breast, moving slowly back and forth until the entire breast is traversed. The Wedge method includes moving the three middle fingers beginning at the outer edge towards the nipple returning to the outer edge of the breast and repeating in a daisy pattern until the entire breast is felt.
Regardless of the method, the objective is to feel the entire breast and observe any changes. To self-examine one's breasts, a woman lies down and places one arm behind her head while using three middle fingers of her other arm to perform the examination. Note that the self-exam is done while lying down, not standing up. This is because when lying down, the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue. The breast should feel soft and smooth to the touch. The woman must pay special attention to the underarm and upper chest areas. She must look for lumps as small as a pea, or as large as a grape.
Three different levels of pressure are used to feel tissue of the entire breast. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast. The woman should tell her doctor if she feels anything else out of the ordinary. If she is not sure how hard to press, she should consult with her doctor or nurse. She should use each pressure level to feel the breast tissue before moving on to the next spot.
Manual methods of breast self-examination require that a woman remember her past findings, so that she can compare her current findings with her memory of past findings. However, this process of comparing with past findings based on her memory is a process that is both unreliable and not quantifiable.
Although the woman might attempt to make manual diagrams each time, and compare the diagrams, this method is not comprehensive, reliable, quantifiable, or reproducible.
Medical professionals performing breast examinations as well as women performing elf-examinations need an objective method to record their findings and compare finding of the current examination with results of examinations from the past.